Cortical diffusivity investigation in posterior cortical atrophy and typical Alzheimer’s disease

• Published in: Journal of neurology Vol. 268; no. 1; pp. 227 - 239
• Main Authors: Torso, Mario, Ahmed, Samrah, Butler, Christopher, Zamboni, Giovanna, Jenkinson, Mark, Chance, Steven
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.01.2021; Springer Nature B.V
• Subjects: Aged; Alzheimer Disease - diagnostic imaging; Alzheimer Disease - pathology; Alzheimer's disease; Atrophy; Atrophy - pathology; Cerebral cortex; Cerebral Cortex - diagnostic imaging; Cerebral Cortex - pathology; Cortex (parietal); Dementia; Dementia disorders; Differential diagnosis; Diffusion Tensor Imaging; Humans; Investigations; Magnetic Resonance Imaging; Medicine; Medicine & Public Health; Neurodegeneration; Neurodegenerative diseases; Neuroimaging; Neurology; Neuroradiology; Neurosciences; Occipital lobe; Original Communication; Temporal cortex; Temporal lobe; Typical Alzheimer’s disease; Minicolumn; Posterior cortical atrophy; Cortical diffusivity; Diffusion tensor imaging
• DOI: 10.1007/s00415-020-10109-w
• ISSN: 0340-5354; 1432-1459

Objectives To investigate the global cortical and regional quantitative features of cortical neural architecture in the brains of patients with posterior cortical atrophy (PCA) and typical Alzheimer’s disease (tAD) compared with elderly healthy controls (HC). Methods A novel diffusion MRI method, that has been shown to correlate with minicolumnar organization changes in the cerebral cortex, was used as a surrogate of neuropathological changes in dementia. A cohort of 15 PCA patients, 23 tAD and 22 healthy elderly controls (HC) were enrolled to investigate the changes in cortical diffusivity among groups. For each subject, 3 T MRI T1-weighted images and diffusion tensor imaging (DTI) scans were analysed to extract novel cortical DTI derived measures (AngleR, PerpPD and ParlPD). Receiver operating characteristics (ROC) curve analysis and the area under the curve (AUC) were used to assess the group discrimination capability of the method. Results The results showed that the global cortical DTI derived measures were able to detect differences, in both PCA and tAD patients compared to healthy controls. The AngleR was the best measure to discriminate HC from tAD (AUC = 0.922), while PerpPD was the best measure to discriminate HC from PCA (AUC = 0.961). Finally, the best global measure to differentiate the two patient groups was ParlPD (AUC = 0.771). The comparison between PCA and tAD patients revealed a different pattern of damage within the AD spectrum and the regional comparisons identified significant differences in key regions including parietal and temporal lobe cortical areas. The best AUCs were shown by PerpPD right lingual cortex (AUC = 0.856), PerpPD right superior parietal cortex (AUC = 0.842) and ParlPD right lateral occipital cortex (AUC = 0.826). Conclusions Diagnostic group differences were found, suggesting that the new cortical DTI analysis method may be useful to investigate cortical changes in dementia, providing better characterization of neurodegeneration, and potentially aiding differential diagnosis and prognostic accuracy.